Beer, Cider Consumption Increases Risk of Gout in Both Sexes

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New research has found that higher consumption of beer and cider was associated with a higher risk of gout in both men and women.¹

“Previous studies of alcohol consumption and incident gout have commonly used nondrinkers as the referent population, such that the effect of reverse causation bias on the examined association remains an open issue. It has been found that, when evaluating the connection between lifestyle factors and health outcomes, reverse causation can influence the magnitude and sometimes the direction of the examined association,” lead investigator Jie-Qiong Lyu, MPH, Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China, and colleagues wrote.¹ “In the case of alcohol consumption, individuals with ill health may have abstained from alcohol, shifting into nondrinking or occasional drinking categories, which may attenuate or reverse a positive association, or exaggerate an inverse association between alcohol consumption and health risk.”

Lyu and colleagues conducted a retrospectivestudy based on a questionnaire-based measure of consumption including 401,128 participants in the UK Biobank between the ages of 37 and 73 years who were free of gout at baseline, from 2006-2010, until follow-up through December 31, 2021.They used multivariable Cox proportional hazards regression models to analyze the incidence of gout and association with alcohol consumption, with a particular consideration of reverse causation bias. The study sought to add further to the body of evidence that alcohol may cause gout.²

The participants involved included 179, 828 men with a mean age of 56.0 years (standard deviation [SD], 8.2) and 221,300 women with a mean age of 56.0 years (SD, 8.0).The investigators found that, overall, current drinkers had a higher risk of gout than never drinkers among men (HR, 1.69 [95% CI, 1.30-2.18]) but not among women (HR, 0.83; 95% CI, 0.67-1.03). Among current drinkers, higher total alcohol consumption was associated with a higher risk of gout among both sexes and more strongly among men (HR, 2.05 [95% CI, 1.84-2.30) than women (HR, 1.34 [95% CI, 1.12-1.61]).¹

Looking at specific alcohol consumption, men consumed significantly more beer or cider (mean, 4.2 pints per week; SD, 4.8) than women (mean, 0.4 pints per week; SD, 1.1). Consumption of champagne or white wine and spirits were both associated with a higher risk of gout, but beer or cider had the strongest association per 1 pint a day, with an HR of 1.60 (95% CI, 1.53-1.67) in mean and 1.62 in women (95% CI, 1.02-2.57).¹

There were some inverse associations between light to moderate consumption of specific alcoholic beverages and gout, but these were eliminated after adjusting for other alcoholic beverages and excluding participants who had reduced alcohol consumption for health reasons, self-reported poor health, cardiovascular disease, cancer, or kidney failure at baseline, or developed gout within the first 2 years of follow-up.¹

“In this prospective cohort study with a careful consideration of potential confounding and reverse causation, consumption of several specific alcoholic beverages was associated with a higher risk of gout among both sexes. The observed sex-specific difference in the association of total alcohol consumption with incident gout may be owing to differences between men and women in the types of alcohol consumed rather than biological differences,” Lyu and colleagues concluded.¹

REFERENCES

1. Lyu JQ, Miao MY, Wang JM, et al. Consumption of Total and Specific Alcoholic Beverages and Long-Term Risk of Gout Among Men and Women. JAMA Netw Open. 2024;7(8):e2430700. doi:10.1001/jamanetworkopen.2024.30700
2. Gaffo AL, Roseman JM, Jacobs DRJr, et al. Serum urate and its relationship with alcoholic beverage intake in men and women: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. Ann Rheum Dis. 2010;69(11):1965-1970. doi:10.1136/ard.2010.129429